Bupivacaine

Chemical name

1-Бутил-N-(2,6-диметилфен ил)-2-пиперидинкарбокс амид (and as hydrochloride)

Gross

C18-H28-N2-O

Characteristics

Local anestetik from group epimerization. The white crystalline powder. It is soluble in 95% ethanol-soluble in water, very soluble in chloroform and acetone.

Of drugs

The drugs - местноанестезирующее . Does the emergence and the nervous system, increasing the threshold for excitability of nerve fibres and reducing the value of the building. As weak lipofilnam reason permeates through lipidnuu nerve sheath inside, and then move kationnuu form (because of the lower pH), sodium ingibiruet Kanala.velicina systemic absorption depends on the dose, concentration and volume of the solution, from the introduction of vascularization injections and availability / lack of epinephrine (adrenalin), or other vazocontrictora. Connection with plasma proteins and variabelna determined by the number of products, the leading systemic blood : the lower the concentration, the higher the relationship with the squirrels. Passes through the placental barrier by passive diffusion. There is a high affinity for the blood protein (about 95%), bad passes through gistogematicalkie barriers (ratio fruit-parent organism is 0.2-0.4). Depending on the way to introduce found in considerable quantities in the well krovosnabjaemah tissue : the brain, miocard, liver, kidneys and lungs. The bone, and epiduralna conductive anesthesia, C_max achieved through 30-45 minutes. T_1/2 in adults is 2.7 hours, the newborn 8.1 hours Treated biotransformation in the liver by conjugation with glukuronova acid. Excreted in the kidneys, and 6% in unchanged Vide.vrajennosti anaesthesia depends on the diameter mielinization speed and the momentum of the nervous fibers. Clinical oppression sequence conductivity of different types of receptors are as follows : sensitive, temperature, taktillnaya, propriotseptus and efferentnaya neiromyshecnaya. Once in the blood system, affects the cardiovascular system and central nervous system. The on / in a large doses of a slowdown conductivity and the suppression of automaticity sinusnogo hub, a jeludockovh arrhythmias, and the driver stops rhythm. There has been a decrease heart discovered (inotroponoe negative effect), and outlines actions. Effects on the central nervous system is oppression oblong of the brain, including breathing (perhaps respiratory depression and coma) or incentive effects on the bark brain to the development of psychomotor stimulation and tremora, moving generalizovannami Sudorogami.mestnaya anaesthesia is a 2-20 min after the introduction of a period of up to seven hours, and it may be prolongirovanie addition solution adrenalin (vazokonstrictorov etc.) in the ratio of 1:200000. After anesthesia was prolonged phase analgezii.0 .75% solution bupiwakaina not used in obstetric practice because of the high incidence of heart failure and respiration in patients. Regionarnaya in / in anaesthesia drug sometimes with fatal consequences. The retrobulbarna anaesthesia described instances of stopping breathing.

Indications

Cutting, epiduralnaya, puncture and provodnikova (in dentistry), retrobulbarnaya anaesthesia, sympathetic blockade.

Restrictions on the use of

Pregnancy, breast-feeding (must stop), liver disease in violation of its functions.

Contraindications

Гиперчувствительност ь to the local anestetikam, especially the epimerization, child (up to 12 years) age.

Side-Effects

Symptoms commencement or oppression CNS (concern, anxiety, dizziness, noise in the ears, impaired vision, limb tremor, Generalized convulsions), the paralysis of limbs, paralysis of the respiratory muscles, aetiology, disruption of sfinkterov, urine retention, parestesia and numbness of limbs, impotence, reduced heart emission blockade sinusnogo unit hypotension, aetiology, jeludockove adults, including ventricular tachycardia, cardiac arrest.

Overdosing

Symptoms : hypotension (up to the collapse), aetiology (possible cardiac arrest), jeludockove arrhythmia, respiratory depression, sputannosti consciousness Sudorogi.lechenie : specific antidote is not available. A symptomatic therapy, including, if necessary, a number of urgent actions : intubation, inhaling oxygen through a mask, the installation of artificial external driver rhythm.

Dosing and Administration

The concentration of the solution depends on the type of anaesthesia : infiltrazionnaya - 0.25%; Provodnikova - 0.25% solution retrobulbarnaya 0.75% solution sympathetic blockade - 0.25% epiduralnaya zone anaesthesia - 0,25-0,75% kaudalnaya 0.25% -0.5% provodnikova 0.5% (with the addition of sports at 1:200000), and the number-adjusted individually.

Directory → Neurotropic funds → Local anaesthetics → Bupivacaine